Researchers test phone support program to help people reduce risk of repeat strokes
Julia Cook has started to eat more vegetables and cut back on salt and sugar. And she credits her coach with helping her adopt this healthier diet.
Now 72, Julia is recovering from a stroke she had a year ago. Through a unique research study called Stroke Coach, she receives regular phone coaching on how she can make lifestyle changes to reduce her chances of having another stroke.
Coaching has always played an important role in sports to improve skills. And increasingly, it has become a critical asset in the workplace, with senior staff mentoring newer hires and businesses bringing in professionals to train staff in everything from office etiquette to new software.
Drs. Janice Eng and Brodie Sakakibara, of the University of British Columbia department of physical therapy, have taken coaching into the medical realm.
Reducing repeat strokes
Dr. Eng came to the idea of Stroke Coach out of concerns that one in three people who have a stroke go on to have another, mostly due to cardiovascular conditions, including high blood pressure.
“Typically, rehabilitation for stroke patients focuses mainly on regaining functions like walking or speech, with little emphasis on lifestyle changes to minimize the risk of a second stroke or a heart attack,” says Dr. Eng. “Stroke Coach was developed to fill this gap.”
Karen Hayley, one of the study’s coaches, delivers educational and behavioural counselling to a dozen older adults living with stroke who are no longer receiving rehabilitation. She calls them for seven telephone coaching sessions of 30 to 60 minutes, over a six-month period.
I asked Karen, who has worked in stroke rehabilitation in the past, what it’s like to meet her clients on the phone rather than face to face.
“There can be challenges, especially at first. It’s definitely different not being able to observe facial expressions or body language. And it takes some practice not to automatically fill in the silences on the other end, to remember that they’re often due to the patient’s level of aphasia or a compromised ability to form thoughts quickly. But once we get to know each other, I’ve found that telehealth actually makes it a bit easier to form a more intimate bond with the participant.”
Julia, who lives in Prince George, BC, has already seen positive results from her regular contact with Karen. “I’ve even convinced my husband to eat healthier. Three times a week I get out and walk between six and eight city blocks, and I attend Tai Chi and exercise classes. As a result, I’ve lost weight and my blood pressure is down!”
Dr. Eng hopes the program will reduce a stroke survivor’s risk of having another stroke or heart attack. Once they have some results, she wants to work with local health authorities to implement Stroke Coach more widely.
“The delivery cost of this service is relatively low and the telehealth approach would allow the program to reach large numbers of Canadians in both urban and rural regions,” Dr. Eng says. “By evaluating the cost-benefits, we can determine whether participants use more or fewer health care services. Hopefully this information will provide the financial justification to adopt the program.”
Stroke Coach is funded by the Canadian Partnership for Stroke Recovery (CPSR) with support from the Heart and Stroke Foundation and other core partners.
It’s a tangible example of how the practical application of research can improve lives. Karen and the other program coaches are providing participants not only with strategies to reduce their risk for further illness, but also one-on-one emotional support and encouragement at a time when many are feeling vulnerable.
Led by Dr. Eng and the GF Strong Rehabilitation Centre, the Stroke Coach program is run by a team of researchers at UBC, GF Strong Rehabilitation Centre and Simon Fraser University, including Drs. Scott Lear and Brodie Sakakibara of CoHeaRT.